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Podcast: Current Trends for Payers - Risk Adjustment Across Multiple Lines of Business

Navigating risk adjustment across multiple lines of business isn’t just complex, it’s a balancing act of shifting regulations, diverse populations, and evolving models. In this episode, we break down the key differences between Medicare Advantage, Medicaid, and ACA, and explain why understanding these nuances is crucial for health plans that manage all three simultaneously. Whether you’re grappling with audits, coding accuracy, or technology gaps, this conversation offers real-world insight and practical strategies for managing multiple lines of business (LOB).

About Our Guest:

Amanda Proctor has over 13 years in risk adjustment coding and specializes in risk mitigation, coding quality and education. She holds multiple certifications in coding and is an AAPC approved instructor.

About the Author

Niki Driscoll is the host of Current Trends for Payers podcast and serves as a Product Marketing Manager at HealthEdge. Her work centers on the trends and innovations shaping the payer market, with a focus on modernization, AI, and next-generation operating models.

Profile Photo of Niki Driscoll